Abstract Details

Title Strengthening Oropharyngeal Muscles as a Novel Approach to Treat Obstructive Sleep Apnea after Stroke: A Randomized Feasibility Study

Topic Sleep

Presentation(s) Sleep Posters (7:00 AM-5:00 PM)

Poster/Presentation
Number 023

Background

OSA is characterized by recurrent obstruction of the upper airway during sleep due to intermittent loss of tone in the throat muscles. Post-stroke OSA is prevalent and has a significant impact on the health of stroke survivors. Continuous positive airway pressure (CPAP), the standard therapy for OSA, is generally poorly tolerated. OPEs are commonly used to improve tongue/throat muscle strength and may be a promising alternative approach to treat OSA.

Objective To determine whether oropharyngeal exercises (OPEs) are feasible as a novel intervention for obstructive sleep apnea (OSA) after stroke.

Design/Methods Forty stroke patients with OSA (AHI≥10/hr) who are unable to tolerate CPAP will be recruited and randomized (1:1) to an OPEs vs sham exercise protocol. They will be asked to perform the exercises for 6 weeks, 5 days per week, for 50 minutes per day. Feasibility will be ascertained by the proportion of enrolled patients who complete >80% of the exercises. OSA severity (assessed by the apnea-hypopnea index (AHI) and lowest oxygen desaturation) and oropharyngeal physiology (e.g., tongue strength) will be collected at baseline, post-training (6-week follow-up) and retention (10-week follow-up).

Results The sample to-date includes 16 participants (11 males, 5 females; age 68.7±9.6 years) who have completed the study (n=8 per study group). The overall adherence was 88.3%. Preliminary analyses revealed that the OPE group had a reduced AHI after training (-18.9% change) compared to sham (-4.3% change). In addition, oxygen desaturation was more likely to increase in the OPE group compared to the sham group (4.6% vs -0.5%, respectively). There was a small increase in tongue strength in the OPE group (5.83% change) compared to the sham group (-1.7% change). The results are still exploratory at this time.

Conclusions Based on this initial sample, a full trial is feasible and results appear to be promising.

Authors/Disclosures
Reeman Marzouqah, MSc PRESENTER	Ms. Marzouqah has nothing to disclose.
	No disclosure on file
Laavanya Dharmakulaseelan, MD	Ms. Dharmakulaseelan has nothing to disclose.
Trevor Jairam, MD (Azure Condominium)	Trevor Jairam has nothing to disclose.
Kathy K. Xiong, MD	Miss Xiong has nothing to disclose.
David R. Colelli, MSc (Sunnybrook Health Science Centre)	Mr. Colelli has nothing to disclose.
	No disclosure on file
Mark Boulos, MD (Sunnybrook Health Sciences Centre)	Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Jazz Pharmaceuticals. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Paladin Labs. Dr. Boulos has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Eisai. The institution of Dr. Boulos has received research support from Canadian Institutes of Health Research. The institution of Dr. Boulos has received research support from Slamen-Fast New Initiatives in Neurology Award. The institution of Dr. Boulos has received research support from Green Mountain . The institution of Dr. Boulos has received research support from RLS Foundation. The institution of Dr. Boulos has received research support from Temerty Centre for AI Research and Education in Medicine (T-CAIREM). The institution of Dr. Boulos has received research support from Heart & Stroke Foundation of Canada. The institution of Dr. Boulos has received research support from Alternative Funding Plan from the Academic Health Sciences Centres of Ontario. Dr. Boulos has received personal compensation in the range of $5,000-$9,999 for serving as a speaker with Jazz Pharmaceuticals.